Chirwere Chine Utachiona Chinowanzoonekwa Zvichida Upenyu Hunopisa Muvanhu vane HIV
Toxoplasmosis chirwere chinorwara chinokonzerwa neprotozoan Toxoplasma gondii ( T. gondii ). Apo inokanganisa uropi (cerebral toxoplasmosis), inofungidzirwa kuti inojekesa AIDS neCenters for Disease Control and Prevention.
Inofungidzirwa kuti inenge 22% yevanhu veUnited States vane utachiona naT . gondii . Inodarika 200,000 mamiriyoni ehuwandu anoshushwa gore roga roga, zvichikonzera kufa kwevanenge 750-zvichiita kuti zvive chikonzero chechipiri chinowanzokonzera zvirwere zvinouraya zvinotapukira shure kweSalmonella chepfu.
Nhamba yehuwandu muAfrica, Southeast Asia, Latin America, uye zvikamu zveCentral neEastern Europe zvinogona kufamba zvakanaka zvakapfuura 50%.
Kubvira kuma1980, kwakave nekuderera kwakanyanya mumatambudziko eT. gondii muUnited States, zvichida zvikurukuru kuchinja kwakanyanya muhutano hwekurima nekuchengetedza kwekudya kwekudya. Uyezve, njodzi ye toxoplasmosis yakaderera pakati pevanhu vanogara nehutachiona hwepamusoro nekuda kwehutachiona hwehutachiona hwehutachiona uye kushandiswa kweprophylactic mishonga inogona kudzivirira zviri nani kugadzirwa kweT. gondii chirwere.
Modes of Transmission
T. gondii inogona kutapira zvisikwa zvakasununguka-neropa, asi inonyanya kupararira mumakati. Kudengenyeka kunowanzokonzerwa ne:
- Kubatana-kumuromo kunosangana nepamusoro kana zvinhu zvakasvibiswa necheka kana kate kitter
- Kudya T. gondii- nyama ine utachiona
- Kudengenyeka kubva kuna amai kumwana panguva yekuzvitakura
Kuberekwa hakufungi sechimiro chekutumira.
Zviratidzo zveToxoplasmosis
Muvanhu, hutachiona hwehutachiona hunove hunofadza kana hunova nehupenzi, zvirwere-firi-sezviratidzo, zvinowanzoperekedzwa nemaronda emaronda ( lymphadenopathy ). Zvisinei, muzvirwere zvekudzivirira zvirwere-kunyanya vanhu vanotapukirwa neHIV vane nhamba dzeCD4 pasi pe100 masero / μL-hutachiona hunogona kuva hwakaipa kusvika pakufa.
Kana isina kusiyiwa, toxoplasmosis inogona kukonzera encephalitis yakanyanya (kupisa kweuropi) nekukuvara kwe retinal. Zvinonyanya kuonekwa neurological zviratidzo ndekutaura uye kushaya simba kwemotokari. Muzvirwere zvakanyanya, kugumburwa, meningitis , optic neramage, uye zviratidzo zvepfungwa zvinowanzoonekwa.
Toxoplasmosis inogona kukonzera kukanganisa kwemapapu, zvichiita kuti kuve-kufanana nekuputika uye zviratidzo zvisinganyatsozivikanwi kubva kuCPP ( pneumocystis pneumonia ). Mune zviitiko zvakakomba, toxoplasmosis inogona kupararira mberi kwehuropi nemapapu kunobatsira chiropa, marrow bone uye mwoyo.
Toxoplasmois in Pregnancy
T. gondii inogona kukanganisa kukuvadza kunowedzera kukura kwemucheche, kazhinji kunokonzera kuora mwoyo kwepfungwa uye kwemuviri. Kunyange zvazvo vana vakawanda vacheche vanotapukirwa naT. gondii vachaonekwa sevasymptomatic, zviratidzo zvingangokura mumakore apfuura.
Imwe yongororo yapfuura neConstonian Western Reserve University yakaratidza kuti, kune vakadzi vane hutachiona hweHIV hwakanyanya, kwakawedzera kuwedzera katatu mumatambudziko ekuparidzirwa kubva kuna amai kuenda kumwana.
Kuongororwa kweToxoplasmosis
Kuongororwa kwe-toxoplasmosis kunotsigirwa nekuongorora kwechipatara zviratidzo uye zviratidzo, pamwe chete nekuongororwa kweropa kana zvisikwa zvemasu. A simple genetic test inonzi PCR (polymerase chain reaction) inogona kushandiswa kugona kuvapo kweT. gondii ma antibodies muropa kana mamwe mvura.
(Mukana wekutapukirwa kwechangobva kuitika, PCR inogona kusakwanisa kuona T. gondii antibodies kwemavhiki masere.Panguva iyi inonzi mawindo , mamwe mapurogiramu anogona kudiwa kuti ave nechokwadi chekutapurirwa, kuitwa kwemavhiki masere kunze.)
Kunyange zvazvo uropi hwechipiyo hunofungidzirwa kuti ndiyo yakagadziriswa yeperebral toxoplasmosis, mumakore achangopfuura yakave yakanyatsoshandiswa nekubatanidzwa kweMRI kana CT kuongorora kuti kuvepo kwehutachiona hutsinye, huchiteverwa nokuedzwa kwePCR kusinganzwisisiki.
Mushonga weToxoplasmosis
Mishonga inokurudzirwa kuvanhu vane hutachiona hweHIV vane nhamba dzeCD4 pasi pe2004, apo maitiro ezvirwere zvezvirwere zvezvirwere zvisingakwanise kurwisa utachiona.
Muzviitiko izvi, Trimethoprin / sulfamethoxale (co-trimoxazole) inowanzova mushonga wekusarudzwa kweprophylactic kudzivirira.
Nezvirwere zvinoshanda, zvinodhaka zvinotevera zvinogona kunyorwa:
- Kusanganiswa kweDaraprim (pyrimethamine) uye sulfadiazine (sulfa-based antibiotic), pamwe nemapirinic acid
- Clindamycin (antibiotic inoshandiswa kurapa zvirwere zvebhakitiriya uye zveprotozoan)
- Spiramycin (ichiri kuongororwa kuongororwa muUnited States, kunyange zvazvo inogona kuwanikwa nehuwandu hweDAA mvumo mukati mekutanga kwekutanga kwekuita pamuviri)
- Mepron (atavaquone)
- Kubatanidzwa kweClindamycin naMeprone
Muna 2015, muumbi wezvinodhaka Daraprim (Turing Pharmaceuticals) akabatwa mukukakavadzana mushure mekunge CEO wavo, Martin Shkreli, akaedza kuwedzera mutengo we 5000%, kubva pa $ 13.50 pamapiritsi kusvika ku $ 750 pamapiritsi.
Kudzivirira kweT. gondii Infection
Mukudzivirira muviri kwakapiwa vanhu (CD4 dzinosvika pasi pe100) kana vakadzi vane pamuviri vane HIV, zvirongwa zvakakosha zvinogona kurayirwa kuderedza dambudziko rekutapukirwa kweT. gondii . Izvi zvinosanganisira:
- Kuva nomumwe munhu achichinja kitty chikafu kana kupfeka mapaundi evhirigi anonyangadza paunozviita iwe pachako. Geza maoko ako shure, uye usachengeta kitty yako mukati kana pedyo nekicheni. Kana zvichibvira, chengetedza kati yako mumba.
- Kubika zvokudya kune kutonhora kwakachengeteka, nekugadzirisa kuti nyama haisi yepini uye kuti maji anobuda zvakajeka. Gadzira uye usuke michero nemiriwo pose pazvinogoneka.
- Kupfekedza girazi pose paunenge uchishanda kana kushanda nevhu, kuchenesa gasi nemaoko kana wapedza.
Kutumidzwa: TOK-so-plas-MOE-sis
Sources:
US Centers for Disease Control and Prevention (CDC). "Toxoplasmosis (Toxoplasma Infection - Epidemiology uye Risk Factors." Atlanta, Georgia; Global Health, Kurwisana Kwezvirwere Zvirwere uye Marariya; January 10, 2012.
Oksenhendler, E ;; Cadranel, J .; Sarfati, C .; et al. "Toxoplasma gondii pneumonia kune varwere vane anun immunodeficiency syndrome." American Journal of Medicine. May 1990; 88 (5): 18-21.
Rabaud, C .; May, T .; Amiel, C .; et al. "Extracerebral toxoplasmosis kune varwere vane utachiona hweHIV." A French National Survey. " Medicine. November 1994; 73 (6): 306-314.
Oksenhendler, E ;; Cadranel, J .; Sarfati, C .; et al. "Toxoplasma gondii pneumonia kune varwere vane anun immunodeficiency syndrome." American Journal of Medicine. May 1990; 88 (5): 18-21.
Minkoff, H ;; Remington, J .; Holman, S ;; et al. "Kutengesa kwakakwana kwe toxoplasma nehutachiona hwevanhu vane hutachiona hweHIV." American Journal of Obstetrics uye Gynecology. March 1997; 176 (3): 555-9.